Montague Michael D, Lewis Jesse T, Moushmoush Obadah, Ryu Jaiyoung
1 West Virginia University, Morgantown, USA.
Hand (N Y). 2019 May;14(3):398-401. doi: 10.1177/1558944717750915. Epub 2018 Jan 7.
Distal radius fractures (DRFs) are 16% of fractures treated by orthopedic surgeons. Obesity's influence on DRF complexity has not been studied. This study was undertaken to determine if body mass index (BMI) affects DRF pattern, treatment, and functional outcomes.
Part 1 was a retrospective review of patients who sustained a DRF after a fall from standing height with no prior reduction or treatment. Radiographs were classified as "simple" or "complex." Part 2 consisted of contacting patients from Part 1 and obtaining a Quick Disabilities of the Arm, Shoulder and Hand (QuickDASH) score. Retrospective review also identified patients who failed initial nonoperative treatment. Fracture pattern, failure of nonoperative treatment, and QuickDASH scores were compared with BMI at the time of injury.
For Part 1, 130 patients (132 wrists) were identified. Average age was 57 years, 77% were female, and average BMI was 28.2 kg/m. Each point increase in BMI increased the chance of having a complex DRF (odds ratio = 1.07). Part 2 identified 50 patients who completed a QuickDASH at an average of 4.6 years after injury. Those with a BMI <25 kg/m (n = 15) had an average QuickDASH score of 37; patients with a BMI ≥25 kg/m (n = 35) had an average QuickDASH score of 18. Increasing BMI was suggestive of a lower QuickDASH score ( P = .08). No significant difference was found with respect to BMI and failure of nonoperative treatment.
A higher BMI increases the odds of a complex DRF. Despite more complex fractures, overweight patients may experience less disability after sustaining a DRF.
桡骨远端骨折（DRF）占骨科医生所治疗骨折的16%。肥胖对DRF复杂性的影响尚未得到研究。本研究旨在确定体重指数（BMI）是否会影响DRF的类型、治疗及功能预后。
第一部分是对从站立高度跌倒后发生DRF且此前未进行过复位或治疗的患者进行回顾性研究。X线片被分类为“简单”或“复杂”。第二部分包括联系第一部分中的患者并获取上肢、肩部和手部快速残疾评估量表（QuickDASH）评分。回顾性研究还确定了初始非手术治疗失败的患者。将骨折类型、非手术治疗失败情况及QuickDASH评分与受伤时的BMI进行比较。
在第一部分中，共确定了130例患者（132侧腕关节）。平均年龄为57岁，77%为女性，平均BMI为28.2kg/m²。BMI每增加1个单位，发生复杂DRF的几率就增加（比值比=1.07）。第二部分确定了50例患者，他们在受伤后平均4.6年完成了QuickDASH评估。BMI<25kg/m²的患者（n=15）的平均QuickDASH评分为37；BMI≥25kg/m²的患者（n=35）的平均QuickDASH评分为18。BMI增加提示QuickDASH评分较低（P=0.08）。在BMI与非手术治疗失败方面未发现显著差异。
较高的BMI增加了发生复杂DRF的几率。尽管骨折更复杂，但超重患者在发生DRF后可能残疾程度较轻。
